Low-FODMAP Diet for Intestinal Inflammation and Autoimmunity

Can a low-FODMAP diet help with small intestinal inflammation and autoimmunity? Let’s discuss a recent study where two groups were fed either a high- or a low-FODMAP diet, expand on what happened to gut bacteria, and more importantly the effect on symptoms.

If you need help with inflammation, digestion, or autoimmunity, click here

Low-FODMAP Diet for Intestinal Inflammation and Autoimmunity

Dr. Michael Ruscio: Can a low-FODMAP diet help with intestinal inflammation and intestinal autoimmunity?

Hi, this is Dr. Ruscio. And let’s talk about a very interesting study that was recently published that looked at what happens in those with intestinal inflammation and intestinal autoimmunity as seen in Crohn’s disease—Crohn’s disease being where people have inflammation and autoimmunity in their small intestine. What happens if we take people with this condition who are somewhat stable and we then put them on either a low-FODMAP diet or a high-FODMAP diet?

And if you’re unaware or unfamiliar with FODMAPs, FODMAPs are essentially types of carbohydrates—high-FODMAP foods, that is. High-FODMAP foods are types of carbohydrates that can feed bacteria and are very fermentable. So they feed the bacteria in your gut. And this can be a good or a bad thing depending on the person.

For many people with gastrointestinal symptoms, issues, problems, things like IBS or small intestinal bacterial overgrowth or Crohn’s disease or ulcerative colitis, these symptoms that typically manifest as gas, bloating, constipation, abdominal pain, loose stools, frequent stools, or even in some cases constipation. This type of approach of eating low FODMAPs can actually be very helpful because it seems that an approach of limiting how much we feed bacteria seems to help.

There was a near doubling of the symptoms in the patients that ate the high FODMAP compared to those that ate the low FODMAP.

Now, what’s interesting here is that the group that ate to feed bacteria, that ate the higher FODMAP diet and had the symptomatic flare. They also saw an increase of bacteria that we think are healthy. Akkermansia muciniphila—I believe is the pronunciation—is an anti-inflammatory bacteria that seems to be healthy, or at least we think. Yet when these patients ate in a way that increased that bacteria, they got sick.

And so I think what’s important to keep in mind, especially if you’re a doctor or if you’re a health care consumer and you’re reading about all this cool stuff we’re learning about all the bacteria in our gut, is that we want to look at these things in a large context, not in the context of, “This bacteria is good. If we can increase this one bacteria, then that should make the patient healthy” because what we see here is we increased that healthy bacteria. But the patients got sick. So looking at this from a bigger picture in terms of how does whatever the intervention is affect someone’s health and well-being?

So in this study, we show that those that have Crohn’s disease—which Crohn’s disease affects about—in 80% of the cases, it affects the small intestine. Those with Crohn’s disease, when they went on a low-FODMAP diet, they looked pretty good symptomatically.

When another group went on a high-FODMAP diet, yes, they saw a healthy bacteria increase because of the bacterial feeding nature of high FODMAPs. But they symptomatically were much worse. In fact, their symptoms were about doubled.

So a low-FODMAP diet has a lot of applications for helping with different types of gastrointestinal conditions including inflammatory bowel disease likely because it starves bacteria. And even though bacteria can be good for us, in a lot of cases, it seems that—and especially for those that have gastrointestinal problems—an approach that limits, or doesn’t feed bacteria, seems to be a favorable strategy.

So this is Dr. Ruscio. I hope this information helps you get healthy and get back to your life. Thanks!

If you need help with inflammation, digestion, or autoimmunity, click here

What do you think? I would like to hear your thoughts or experience with this.

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

Comments

I had trouble sticking to a low fodmap diet because it eliminates a lot of fruit. I’ve found that Intermittent Fasting has really helped me the most, with an 8 hour eating window. Although I still try to eat a mainly paleo diet. With IF, fewer foods seem to bother me but of course that doesn’t mean I can eat foods with abandon that I know really aggravate my SIBO. related bloating.

O.K. Have had success w the SCD diet with the SIBO issues, since Jan 2016. I tried the FODMAPS first, in trying to starve the little Bas***ds into submission. DID not notice any improvements. Read about the SCD, looked at the “difference” in what was on the “Can Have” list vs. the “Can’t”. Really made a difference in about 4 days. Have stuck with it & added using Atrantil* herbal supplement from a Dr. Kenneth Brown. HOLY MOTHER OF PEARL, did that change the game. 20 days later, and small amounts of white rice (very well chewed, or breakfast potatoes or local fresh made non-GMO corn tortillas later….NO issues with Bloat or constipation. BUT the diet really started the change in the correct direction. Herbs were the coup de grace! FEEL worlds better and had no other options now that we are retired & living on Soc Sec $. Could not afford the Rx or get to the USA to have treatment by anybody. Retired to Belize where clean fresh foods are safe & non-toxic. Wanted to let other know about a cost effective option once they tackle the diet issues. CMN

I have to agree about the low FODMAP diet. I had severe UC for 3 years to the point I almost lost my colon. I tried various diets to help heal me from a nutritional standpoint. SCD didn’t work. Paleo didn’t work. AIP started to work. But after reading about FODMAPs for about 8 months I finally eliminated these foods entirely and saw more rapid healing. Nutritional healing alone did not get me into my blissful remission, but I truly feel that finding the right diet combo for IBD patients is crucial. Thanks for putting out such great content Dr R. I’ve really enjoyed listening to your podcasts and shorts.

Dr Ruscio, how do I know which diet would be most helpful? I’ve tried a few and none seem to give me enough relief. When I did anti-sugar it helped my brain fog but not my terrible GERD. When I did low fodmap it definitely helped some of my reflux but not my brain fog. When I’ve done high fat and protein I gained weight really quickly, but maybe my carb intake wasn’t low enough. Part of my problem is that any supplement I take in pill form is impossible to get down because of my esophageal dysmotility (this started after I was on a trycyclic antidepressant and PPI’s 2 years ago at the start of my health journey) – when I do get pills down, they give me stomach pain as if the pill is hard to breakdown and my intestines are too sensitive. I just read your new book and I’m loving the 8 step protocol – but I’m worried for step 2 and 3 because of all of the pills. When i take oregano oil (and I do feel relief from it), I take it in its oil form a drop in a glass of water. I just started the low carb because I am of European descent and it definitely helps my reflux. Looking forward to really getting started on the 8 step protocol (apart from the cleanse/fast because I have vasovagal syncope). How do you advise I move forward with step 2 and 3? I think I’ll attempt the whole paleo 30 low carb with a low histamine twist because of my vasovagal, chest tightness when breathing and inability to take a deep breath, and anxiety type symptoms. I have been fully tested for autoimmunity and all negative so I think my SIBO and possible yeast are more significant from a history of antibitoics, antacids, and the tricyclic anti depressant. Thanks for any advice you’re able to provide! I’m doing some research on your website now 🙂